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Low-income health care takes biggest hit with New Hampshire House budget – NH Business Review

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Low-income health care takes biggest hit with New Hampshire House budget – NH Business Review


No one will feel the effects of the two-year budget passed by the New Hampshire House more, if it is enacted, than New Hampshire low-income residents who need help paying for, and accessing, health care.

The $15.36 billion FY 2026-27 budget passed by the House Thursday, April 10, cuts Gov. Kelly Ayotte’s $16 billion proposal by $643 million. It takes its deepest cut from the state Department of Health and Human Services — $269 million less than what was proposed by Ayotte in February. That includes $46 million in “back-of-budget” cuts, which aren’t specified in the state budget, but up to the agency head to come up with.

Many of those cuts are to Medicaid-related services; programs that provide health care support; resources and aid for the elderly, people with disabilities and those with low incomes. It eliminates programs designed to reduce health care costs overall in the state, and raises fees and costs for low-income people who receive Medicaid.

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Ayotte said this week she hopes to work with the New Hampshire Senate, which has until June 5 to amend the House proposal, including cuts to mental health and disability services. Any disagreements between the House and Senate are worked out in a committee of conference, and the two-year budget goes into effect July 1.

The DHHS budget represents a massive share of the services the state provides to residents. It was $6.58 billion in the current fiscal biennium, representing 44% of the states’ expenditures.

House Republican budget leaders say the deep DHHS cuts from what Ayotte proposed are necessary to help close an $800,000 gap in their revenue projections as compared to the governor’s.

But those who opposed the budget said it goes too far, particularly when it comes to the state’s low-income residents.

“This budget will have devastating and long-lasting effects on the neediest in our state,” Rep. Mary Jane Wallner, D-Concord, said during the House Ways and Means approval process. Thursday’s vote was along party lines, with Democrats, in the minority, attempting to amend some of the cuts or fee increases. Most of those efforts were unsuccessful.

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“If enacted, these proposed cuts will certainly have an impact on the lives, dignity, and futures of Granite Staters,” Kate Frey, vice president of advocacy at New Futures, said in an online statement Thursday. New Futures is a nonprofit that provides data and research on the health of New Hampshire children and families.

“The people who will feel these cuts the hardest are families struggling to make ends meet, older adults dependent on critical support services, people accessing treatment and recovery for substance use, health care providers reliant on state investment, and working individuals who rely on basic health care and economic opportunities,” Frey said.

Many of the biggest cuts, as well as fee hikes, are for families who receive Medicaid, which provides health care to people with low incomes, disabilities and the elderly. More than 182,000 New Hampshire residents, 13.4% of the state’s population, receive Medicaid, including 30.1% of children in the state and 64% of residents living in nursing homes, according to federal statistics. An additional 60,000 are included in the Granite Advantage Medicaid expansion program for residents between 19 and 64 who have a household income at or below 138% of the federal poverty guideline, which would be $21,597 for an individual.

Most Medicaid programs in New Hampshire are overseen by DHHS.

Among the House budget provisions affecting health care for low-income state residents:

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  • A required premium of 5% of income premium for Medicaid recipients above the federal poverty guideline. The premium would apply to households with no children that earn 100% or more of the federal poverty guideline ($15,650 for an individual, modified annual gross income, which includes all income, not just wages) and 255% or more of the federal poverty guideline for families with children (for instance, $67,957 of modified annual gross income for a three-member family). Those who oppose the premium characterize it as an income tax on those who can least afford it.
  • An increase to the copay for prescription drugs for Medicaid recipients to $4 from the $1 and $2 most recipients paid. Those who oppose it say that it may seem like a small amount, but isn’t for many families who struggle to buy food or heat their house. Rep. Ken Weyler, R-Kingston, the chair of the House Finance Committee, said the increase will deter people who take advantage of the system by getting medication they don’t need.
  • Cuts the Medicaid reimbursement rate by 3%, which means $52.5 million less to providers over the next two years, which will cause reductions in services and some health care providers shutting down, critics of the move have said.
  • A $31.4 million reduction in funding for developmental disability services over two years, which would also reduce federal Medicaid matching funds, for a $62.8 million (6.4%) cut that would affect the developmental disability services waitlist for anyone needing increased aid, children aging out of school-based services and individuals with disabilities moving into the state.
  • Suspends the WIC farmers market nutrition program, which provided $30 a month to WIC recipients to buy produce at farmers markets.
  • Suspends congregate housing services for elderly residents who are eligible for Medicaid, but also increases the amount counties must contribute for long-term care for the elderly, from 2% to 3%, capped at a statewide total of $135.8 million in FY 2026 and $139.9 million in SFY 2027.
  • Cuts $37.8 million over two years for community mental health, which would mean cuts in service or elimination of community mental health centers, the Rapid Response Team, and other initiatives to better serve people with mental health challenges, including to Mission Zero, a program that aims to provide mental health services that free up emergency room space used to board people suffering from mental illness.
  • Changes to how the Alcohol Abuse Prevention and Treatment Fund is financed that limit the money to opioid-related programs.
  • Eliminates the state’s family planning program, a $1.7 million cut, which provides contraception and prenatal services, as well as cancer screening and sexually transmitted disease prevention resources and testing.
  • Suspending the State Loan Repayment Program for health care professionals, including dentists, who take jobs in underserved areas for 36 months or more, and in exchange the state pays a portion of their student loans. The program was created to incentivize health care work in areas that don’t have access to providers.
  • Eliminating the Tobacco Cessation and Prevention Program, which is designed to reduce the prevalence and consumption of tobacco use, the top cause of preventable death in the state, as well as contributing to a large variety of health issues, including in children who breathe second-hand smoke. According to Quit NH, the state’s initiative to combat the effects of smoking, tobacco use costs New Hampshire $1.5 billion annually both directly and indirectly, including medical costs and lost productivity from illness related to it.
  • Eliminating the New Hampshire Commission on Aging, which works to access federal Older American Act funds.
  • Eliminating the Prescription Drug Affordability Board, which works to limit prescription drug costs.
  • Eliminating four Dept. of Education positions that implement prevention and student wellness programming in schools (these are non-vacant positions).

Ayotte said before the vote that she plans to work with the Senate on getting some of what she proposed back into the budget, including funding for community mental health centers and the waiting list for services for people with developmental disabilities.

Adding to the outlook for Medicaid recipients and health care in New Hampshire is uncertainty about what will happen on the federal level. New Hampshire has a trigger law that, if federal funding for Medicaid drops below 90% of the program’s cost in the state, the Granite Advantage program will be terminated.

Congress is in the midst of considering changes to the Federal Medical Assistance Percentage that would require states to come up with a bigger percentage of their Medicaid share. Some of the proposals in the House budget had that in mind, including a shift to lower-cost medications and services. But the state would still have to come up with millions, which would likely include elimination of Granite Advantage, the expansion that provides Medicaid to more than 60,000 state residents.





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N.H. city’s refusal to fly ‘Save Women’s Sports’ and ‘An Appeal to Heaven’ flags is unconstitutional, appeals court rules – The Boston Globe

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N.H. city’s refusal to fly ‘Save Women’s Sports’ and ‘An Appeal to Heaven’ flags is unconstitutional, appeals court rules – The Boston Globe


A federal appeals court has ruled officials in Nashua, N.H., engaged in unconstitutional viewpoint discrimination when they denied requests to fly certain politically charged flags, while allowing others, on the city’s “citizen flag pole.”

Bethany and Stephen Scaer, whose requests to hoist banners with the slogans “Save Women’s Sports” and “An Appeal to Heaven” were rejected, teamed up with the Institute for Free Speech and filed a lawsuit in 2024 alleging their First Amendment rights were violated.

The trial court in New Hampshire initially concluded the Scaers hadn’t demonstrated a likelihood that their case would succeed, since the flags approved for display at City Hall constitute government speech. But three judges on the First Circuit Court of Appeals reversed that decision Monday, finding that the flagpole in question had actually been a venue for private speech all along.

The case relates to one Boston lost in 2022, when the US Supreme Court ruled unanimously that the city had unconstitutionally rejected an application to fly a Christian flag.

Even though Nashua sought to clarify its policy in response to that 2022 precedent, the city’s process for deciding which flags from the general public would be allowed still didn’t convert private speech into government speech, according to the First Circuit ruling.

“Nashua was doing no more than simply approving that private speech with which it agreed,” Judge Sandra L. Lynch wrote in the ruling, joined by judges Gustavo A. Gelpí and Jeffrey R. Howard.

In a statement, Beth Scaer said the ruling offers a sense of vindication.

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“No one should have to face government censorship for expressing their beliefs,” she said. “We’re thrilled with this victory for free speech rights throughout New England.”

Nathan Ristuccia, an attorney with the Institute for Free Speech who argued the case on appeal, said his team is delighted by the ruling.

“As the First Circuit recognized, governments cannot get away with censorship by labeling that censorship ‘government speech,’” Ristuccia said.

Before the lawsuit was filed, Nashua Mayor James W. Donchess said the city declined to fly the “Save Women’s Sports” flag because officials interpreted it as implying transgender people should face discrimination.

The Scaers, who regularly demonstrate against gender-affirming medical interventions for minors and against inclusion of transgender athletes in women’s and girls’ sports, rejected the notion that their messaging is transphobic.

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As for the “Appeal to Heaven” flag, which features a pine tree, Donchess said city officials want to avoid endorsing the additional meaning it has taken on in recent years.

The banner emerged during the American Revolution, with a nod to the Pine Tree Riot in New Hampshire, an act of American resistance that preceded the Boston Tea Party. More recently, the flag has also been used by Christian nationalists, including some who carried it to the US Capitol on Jan. 6, 2021, when a violent mob delayed the certification of President Trump’s 2020 electoral defeat.

An “Appeal To Heaven” flag is pictured as people gather at Independence Mall to support President Donald Trump as he visits the National Constitution Center to participate in the ABC News town hall on Sept. 15, 2020, in Philadelphia. Michael Perez/Associated Press

In her application to raise the “Appeal to Heaven” flag, Beth Scaer said she wanted to honor the soldiers from Nashua who fought and died at the Battle of Bunker Hill in 1775. She and her husband said their request has nothing to do with the Capitol riot.

Nashua has also declined to fly several other flags since the 2022 policy update, including a “pro-life” flag and a Palestinian flag, according to the lawsuit.

Nashua’s attorney, Steven A. Bolton, said on Tuesday that the city has not yet determined whether to file an appeal. He noted that the appellate ruling calls for the trial court to grant interim declaratory relief while the case proceeds.

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Bolton said the city has stopped inviting community members to fly their own flags.

“A new policy was adopted more than a year ago, and we no longer use the term ‘citizen’s flag pole,’” he said. “We no longer accept applications from other parties to fly flags on any of the poles on the City Hall grounds.”


Steven Porter can be reached at steven.porter@globe.com. Follow him @reporterporter.





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New Hampshire

Nashua man dies after car crash and fire on Route 101 in Candia, investigation ongoing

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Nashua man dies after car crash and fire on Route 101 in Candia, investigation ongoing


CANDIA, NH (WGME) – Early Monday morning, a Nashua man died following a crash on Route 101 eastbound in Candia, New Hampshire.

Joseph H. Lavoie, 58, of Nashua, had been driving along Route 101 eastbound near Exit 3 when he lost control of his car, resulting in a drift off the right side of the highway before striking the cement bridge at the Old Candia Road overpass.

State troopers arrived at the scene to find Lavoie’s car on fire, though several passing drivers had helped to pull Lavoie out of his car. The fire was quickly extinguished.

Lavoie was taken to the hospital where he later died from his injuries.

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The crash remains under investigation. Anyone with information that may assist the investigation is asked to contact Trooper Kevin LeDoux via email at Kevin.P.LeDeoux@dos.nh.gov.



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New Hampshire’s Energy Landscape in 2025 – Concord Monitor

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New Hampshire’s Energy Landscape in 2025 – Concord Monitor


The biggest national news in 2025 often involved energy — how to make it, who gets to use it, who is going to need it. New Hampshire has sidestepped most of those questions so far but still saw plenty of energy news.

Goodbye, coal

The closing of the Merrimack Station power plant in Bow sounds like New Hampshire’s biggest energy news of the year and got a lot of national coverage along the lines of “New England shuts down coal!” but to be honest, it didn’t make much difference. The plant had been winding down for years, having run for fewer than 30 days in 2024, and would almost certainly have shut in a year or so because it lost what is known as capacity funding.

The more interesting question is what will replace it. Granite Shore Power President Jim Andrews has long touted plans to turn Merrimack Station, as well as the long-closed Schiller site in Portsmouth, into 21st century power plants using batteries and solar power, with perhaps some offshore wind assembly on the shores of the Piscataqua River.

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But Donald Trump was elected and promptly began to trash wind and solar power, yanking subsidies and throwing up regulatory roadblocks. Granite Shore now says it is looking at all possibilities.

Both sites have excellent connections to the power grid, which makes them very valuable.

We need more electricity

New Hampshire, like New England in general, have not been swamped with proposals to build massive, power-hungry data centers for bitcoin mining and artificial intelligence. Those proposals have led to forecasts that national demand for electricity will spike by a quarter or more within a few years.

ISO-New England, the group that runs the six-state power grid, projects an 11% increase in electricity demand over the next decade, largely driven by the electrification of heating and transportation. That’s a lot, especially after years of stagnant demand, but it’s not panic-inducing.

Sidestepping regulation

New Hampshire is set to become the first state to allow energy providers to skip most utility regulation if they don’t connect to the grid. Supporters say it adds much-needed flexibility to the hidebound energy industry while critics call it a sop to very large energy users, such as data centers. It’s not clear how much it will be used, but it’s an interesting experiment, at least.

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Community solar OK, wind not so much

The Republican-controlled legislature isn’t quite as anti-solar power as President Trump but it shows a lack of enthusiasm for renewable energy. They passed a bill loosening stormwater runoff rules for solar arrays but tightened the Renewable Energy Fund and as the year ended, they were looking to make severe changes to the Renewable Energy Portfolio.

On the other hand, there’s community solar. Thanks to a series of bills over the past few years, arrays up to 5 megawatts can share production with multiple customers, making big projects that opened or are being built in Exeter, Bedford, Derry, Warner and now Concord financially feasible. It seems likely that 2026 will set a record for the most solar added to the grid in New Hampshire. If the legislature would let private companies be community-solar customers, we’d do even better.

As for wind power, legislators echoed Trump’d hatred of the industry. Gov. Ayotte agreed to shorten the name of the Office of Offshore Wind Industry Development and Energy Innovation to simply the Office of Energy Innovation as part of removing virtually all support for wind power on land or in the sea. Not that we gave much support to begin with.

Ironically, this month saw New England receive a record amount of power from wind turbines — more than 1,600 megawatts at one point — as the Vineyard Wind offshore farm finally got up to speed.

What about natural gas? Nuclear? Heating oil?

As has been the case for many years, natural gas was the fuel to supply about half of New England’s electricity in 2025 and heating to about one-fifth of New Hampshire’s homes.

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Many politicians are making noises about building more pipelines to bring in more natural gas from New York or Pennsylvania; Gov. Ayotte expressed support for bringing the proposed Constitution Pipeline, which was killed in 2020, back to life. Many argue that such work would be prohibitively expensive and make the region even more dependent on a single type of fuel.

Natural gas has traditionally been very cheap compared to other types of fuel but its price is increasingly affected by global patterns because of an increase in exports.

A separate question is whether the push to electrify the region’s heating can cut into our use of heating oil. Northern New England is by far the national leader in using that dirty fuel for heating; switching to electric heat pumps is almost always cheaper and definitely cleaner. New Hampshire is one of five states in the New England Heat Pump Accelerator, which looks to spend $450 million from Joe Biden’s 2022 Inflation Reduction Act to encourage more heat pumps.



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